A Study of CART-PSMA-TGFβRDN in Patients With Metastatic Castration Resistant Prostate Cancer

A Phase 1 Open-Label, Multi-Center Study of PSMA Targeted Genetically Modified Chimeric Antigen Receptor T Cells in Patients With Metastatic Castration Resistant Prostate Cancer

Sponsors

Lead Sponsor: Tmunity Therapeutics

Source Tmunity Therapeutics
Brief Summary

Multi-center, open-label, Phase 1 study of the safety, tolerability and feasibility of dosing patients harboring metastatic castration resistant prostate cancer (mCRPC) with genetically modified autologous T cells (CART-PSMA-TGFβRDN cells) engineered to express a chimeric antigen receptor (CAR) capable of recognizing the tumor antigen prostate-specific membrane antigen (PSMA) and activating the T cell.

Detailed Description

This is a Phase 1 single-arm study designed to identify the dose and regimen of CART-PSMA- TGFβRDN cells that can be safely administered intravenously following the lymphodepletion (LD) regimen to patients with metastatic castration resistant prostate cancer (mCRPC). Following Dose Escalation, a Cohort Expansion will enroll patients to further explore the safety and tolerability of the selected dose and schedule.

It is anticipated that up to 50 patients will enroll in this study in both dose escalation and cohort expansion.

Overall Status Recruiting
Start Date November 22, 2019
Completion Date November 30, 2036
Primary Completion Date November 30, 2022
Phase Phase 1
Study Type Interventional
Primary Outcome
Measure Time Frame
Dose Escalation: Dose Identification of CART-PSMA-TGFβRDN Up to 2 years
Cohort Expansion: Safety of CART-PSMA-TGFβRDN Up to 2 years
Secondary Outcome
Measure Time Frame
Preliminary efficacy of CART-PSMA-TGFβRDN as assessed by biochemical Objective Response Rate (ORR) Up to 2 years
Feasibility of CART-PSMA-TGFβRDN Up to 2 years
Peripheral expansion and persistence of CART-PSMA-TGFβRDN Up to 15 years
Enrollment 50
Condition
Intervention

Intervention Type: Biological

Intervention Name: CART-PSMA-TGFβRDN

Description: Intravenous administration of genetically modified autologous T cells engineered to express a protein capable of recognizing the tumor antigen prostate-specific membrane antigen (PSMA), as well as a dominant negative TGFβ receptor

Arm Group Label: Dose Escalation

Intervention Type: Drug

Intervention Name: Cyclophosphamide

Description: Patients will receive cyclophosphamide and fludarabine lymphodepletion chemotherapy followed by the investigational product, CART-PSMA-TGFβRDN genetically modified T cells

Arm Group Label: Dose Escalation

Intervention Type: Drug

Intervention Name: Fludarabine

Description: Patients will receive cyclophosphamide and fludarabine lymphodepletion chemotherapy followed by the investigational product, CART-PSMA-TGFβRDN genetically modified T cells

Arm Group Label: Dose Escalation

Eligibility

Criteria:

Inclusion Criteria:

- Confirmed histologic diagnosis of prostate cancer and have mCRPC, with castrate levels of testosterone (<50 ng/mL)

- PSA measurable disease per Prostate Working Group 3 (PCWG3) criteria

- Prior therapies defined as at least 2 prior lines of systemic therapy for prostate cancer, including at least one second generation androgen receptor inhibitor and/or CYP17α inhibitor. At least one line of prior therapy must be in the mCRPC setting

- Estimated estimated glomerular filtration rate ≥ 60 mL/min by Modification of Diet in Renal Disease criteria

- Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) ≤ 2.5x the upper limit of normal (ULN); patients with hepatic metastases ALT and AST ≤ 3.0 x ULN

- Serum total bilirubin < 1.5 mg/dL unless patient has known Gilbert's Syndrome, then serum bilirubin ≤3 mg/dL

- Serum albumin ≥ 3.0 g/dL

- Left ventricular ejection fraction (LVEF) ≥ 50%. LVEF assessment must have been performed within 8 weeks of enrollment

- Hemoglobin ≥ 8 g/dL

- Absolute neutrophil count ≥ 1000/μL

- Platelet count ≥ 75,000/μL

- Patients who have not undergone bilateral orchiectomy must be able to continue gonadotropin-releasing hormone (GnRH) therapy during the study

- Eastern Cooperative Oncology Group (ECOG) score of 0 or 1

- Toxicities from any previous therapy must have recovered to Grade 1 or baseline

- Patients of reproductive potential agree to use of approved highly effective contraceptive methods

Exclusion Criteria:

- Active invasive cancer, other than the proposed cancer included in the study, within 2 years prior to screening, unless treated with curative intent

- Current treatment with systemic corticosteroids (defined as a dose greater than the equivalent of prednisone 10 mg/day)

- Active autoimmune disease (including connective tissue disease, uveitis, sarcoidosis, inflammatory bowel disease or multiple sclerosis) or a history of severe autoimmune disease requiring prolonged immunosuppressive therapy (any immunosuppressive therapy within 6 weeks prior to screening visit)

- Current human immunodeficiency virus (HIV), hepatitis C virus, hepatitis B virus infections; Patients who are hepatitis B core antigen positive, hepatitis B surface antigen negative, should have a quantitative viral load measured; If viral load is undetectable, the patient will not be excluded if hey are able to be treated with anti-viral medication for at least 7 days prior to lymphodepletion until at least 6 months after infusion with viral load and ALT monitoring

- Active or uncontrolled medical or psychological condition that would preclude participation

- Prior allogeneic stem cell transplant

- Active and untreated central nervous system malignancy

- History of severe infusion reaction to monoclonal antibodies or biological therapies, or to study product excipients that would preclude the patient safely receiving CART-PSMA-TGFβRDN cells

- History of being previously treated with a J591 antibody-based therapy

- Active or recent (within the past 6 months prior to apheresis) cardiovascular disease, defined as (1) New York Heart Association Class III or IV heart failure, (2) unstable angina, (3) a history of recent (within 6 months) myocardial infarction or sustained (> 30 second) ventricular tachyarrhythmias, or (4) cerebrovascular accident

- Have inadequate venous access for or contraindications for the apheresis procedure

- Must agree not to participate in a conception process or must agree to a highly effective method of contraception

Gender: Male

Minimum Age: 18 Years

Maximum Age: N/A

Healthy Volunteers: No

Overall Contact

Last Name: Karen Chagin, MD

Phone: 215-966-1472

Email: [email protected]

Location
Facility: Status: Contact: Contact Backup:
Columbia University Medical Center | New York, New York, 10032, United States Recruiting Mark Stein, MD
Thomas Jefferson University | Philadelphia, Pennsylvania, 19107, United States Recruiting Matthew Carabasi, MD
Sarah Cannon Research Insitute | Nashville, Tennessee, 37203, United States Recruiting Meredith McKean, MD 615-329-7478 [email protected]
University of Washington Medical Center | Seattle, Washington, 98195, United States Recruiting Michael Schweizer, MD 206-606-1024 [email protected]
Location Countries

United States

Verification Date

September 2020

Responsible Party

Type: Sponsor

Keywords
Has Expanded Access No
Condition Browse
Number Of Arms 1
Arm Group

Label: Dose Escalation

Type: Experimental

Description: Dose escalation of intravenous CART-PSMA-TGFβRDN cells for patients with metastatic castration resistant prostate cancer

Patient Data No
Study Design Info

Intervention Model: Sequential Assignment

Intervention Model Description: Sequential dose escalation

Primary Purpose: Treatment

Masking: None (Open Label)

Source: ClinicalTrials.gov